Cystoscopic x-ray table



Aug. 9, 19 A. MUTSCHELLER ET AL CYSTOSCOPIC X- RAY TABLE Filed May 25, 1926 3 Sheets-Sheet 1 flrZ/zur NV g ler arl men BY w \MU @Q M ATTORNEY d9, 9 A. MUTSGHELLER ET AL 1 CYSTOSCOPIC X-RAY TABLE I Filed May 25, 192 3 Sheets-Sheet -2- JET-IRES I IN EN RS a/WWW M ATTORNEY A g- 1932- A. MUTSCHELLER ET AL 0 CYSTOSCOPIC X-RAY TABLE Filed May 25, 1926 3 Sheets-Sheet 3 =FJLISLTRES A'YTORNEY Patented Aug. 9, 1932 UNITED STATES ARTHUR MUTSGHELLER, OF- NEW YORK, N. Y., AND CARL JOI-IAN LARSEN OF EAST ORANGE, JERSEY, A SSIGNOBS TO WAPPLER ELECTRIC. COMPANY, INC., F

LONG ISLAND CITY, NEW YORK, A coRPonA'rIonoF NEW YORK cxsroscorrc x-nAY' TABLE Application filed May 25,

Our invention relates to cystoscopic X-ray tables of the type in which a seat is provided for the patient, in order to enable him to recline or sit up, as the case may be, while being examined cystoscopically as to the condition of certain organs, and also while said organs are'being. exposed to the action of X- rays, as for instance in making radiographs.-

()ur improved table is specially constructed and arranged for use in the examination and treatment of the genito-urinary tract, and various organs and parts immediately associated therewith. a

An'important feature of our improved apparatus is its facility to enable radiographicex a-minations to be made of various organs, such for instance, as the kidneys, the patient first occupying one position and then being moved into a different position, so that the precise location of the organs, with the patient resting in one position, can be contrasted withthe location of the organs when the patient. is resting in a difierent position.

More particularly stated, we seek to prove the cystoscopic X-ray table by connecting withit a rocking board, so formed and arranged as to admit of tilting to different de grees independently of the general incllnation of the table as a whole, and adapted to serve as a seat for supporting all or practically all of the patients weight when the patient is sitting up, and to support a smaller proportion of the patients weight, varying with the position of the patient, as he reclines or is raised or lowered into different recumbent positions. a v

It has heretofore been customary, inradiographing various organs and parts of the-human body, to employ a cystoscopic table carrying the X-ray tube, together with an X-ray plate holder or cassette, and an X-ray filter. This Xrray filter is instrumental in reducing the undesirable secondary radiation. It has also been customary to so construct and ar range the apparatus as a whole that when the table. with the patient resting thereupon, is tilted to different angles in. order to bring the patientsbody into different degrees'of' inclination, the X-ray tube, the X-ray plate and the X-ray filter are thereby automatically 1926. Serial Nd. 111,479.

tion of various internal organs,'becaus'e such organs are very transparent to X-rays. It is therefore customary to inject into organs of this character a small quantity of a solution which is relatively opaque to the X-rays. This has practically the effect ofrrendering the organs vsible,-orat least discernible during the X-ray examination and places them in suitable condition for taking radiographic pictures. For X-ray examination of the kidneys, and for diagnosis of strictures of the meters, as well as for studying changes in the positions of the kidneys relatively to other parts of the body,it isthe usual practice to inject the opaquesolution by means of one or more catheters, and this is most conveniently done by using in connection with such catheters some-appropriate form of'catheter izing cystoscope;

It has recently become known that oftentimes useful data as to the condition of the kidneys and various other internal organs here contemplated may be obtained b contrastmg the position of the 0rgans,;wh1le the patient occupies one position, with the relative position of the same organs when the patient occupies a difierent position; for instance, to first observe the locationof the kidneys while the patient occupies. a reclining position, and thenby way of contrast to note the relative location of the kidneys while thiIpatient sits upright.

owever, in making examinations of this kind, 'under 'iconditions where the observations are to be made by aid of X-rays and the results are to be shown upon radiographs, a practical difliculty has arisen. hen the kidneys are to be shown upon the radio graph, and when for this purpose the afore-' said'solution opaque to'X-rays is injectedinto' the kidneys and tubular-"passages leading thereto, it often happens that the patient,

by exerting himself in shifting from one vposition tofanother, causes muscular contractions to take place in parts immediately adace nt'the kidneys; and these muscular contractions may expel all or a considerable portion of the opaque fluid from the kidneys. It is therefore in practice necessary to reduce to a minimum all necessity for the patient to make any muscular exertion, at least after the opaque fluid has been injected and before the radiographs have been taken.

A very important purpose of our invention is to so improve the cyst'oscopic table, by

adapting it for use with our improved rocking seat, that by its'aid the patient maybe readily shifted from one position to another, as for instance from a recumbent position to a sitting position, without the exertion of any muscular effort on his part for the purpose; In other words, we so arrange our rocking board and so connect it with the table, that the patient lying on the table and resting. partly upon our improved rocking board may be easily, slowly and gradually raised from-a reclining position to a sitting position, without any exertion upon his part, and without any dangerof sliding obliquely downwarch'no matter to what angle of inclination the table as a whole may be tilted.

.Byr'neans. of our table with its rocking board, the kidneys and various other organs can be ra'diographed so as to disclose not only their form and. general condition, but also toreveal any dropping or other displacement in theirposition relatively to other parts of the body, as the patient is shifted from one bodily position to another. .It frequently happens that disease of an organ such. as a kidney, or disease of the various ligaments, membranes, arteries, veins and the like lead ing to and connected with th'e'organ, may be readily detected by noting changes'in the relative. position of the organ as the patient.

accessibility, by the operator, to various organs of the patient which are to be examined or. treated by aid of our invention.

Reference is made tovthe accompanying p drawings forming a part of this specification, and in which like reference characters indicate like parts throughout the several figures.

Figure-1 is a side elevation of our improved cystoscopic X-ray table,; with its rocking nism, certain parts being brokenaway.

@Figure 3, is a section on the line 3-3 of Figure 1, looking in the direction indicated by the arrows.

Figure 4 is a detail of the'gearing shown in the left hand portion of Figure 2, certain parts beingbroken away;

v Figure 5 is a section on the line 55 of Figure 4, looking in the direction indicated by the arrows.

Figure 6 is a side elevation of the table,and shows in dotted lines the patient resting upon itin a recumbent position, this view indicating the relative positions of the X-ray tube, the X-ray plate holder and the X-ray filter relatively to various port-ions of the table and the patient resting thereupon.

1 Figure 7 is a side elevation showing the position of the table with the X-ray tube, the plate holder, and various movable parts, with the patient resting upon the table, butoc-- 'positions of the X-ray' tube and plate holder and various movable parts of the tab-1e relatively to the patient, who here occupies'a sit? ting position. 7 v f r 1 Figure 9 is a detail showing the X-ray filter and mechanism for actuating the same, but

upon a larger scale thanthat of Figure 8.

Figure 10 is a plan view of the rocking board. 7 A pair of side frames 9 and 10 are connected by cross bars, one of whichis shown at 11, and these side frames are mounted upon castor rollers 12, 13. V r i 1 The back board of the table appears at 14, and connected with it are a pair of hanger arms exactly alike, one beingshown at. 15. This back board 14 is provided with asuitable top portion 16 which supports the patients back when the patient occupies a re clining position during an examination. Ex.- tending into each of these two arms is a" screw bolt 17, provided with a head 18, shown more particularly in Figure 3. I 1

' Encircling the bolt 17 is a sleeve 19, which serves as a journal neck and extends through a bearing 20 with whichthe side frame 9'is provided, and also througha bearing 21, as may beunderstood from Figure 3.

The bearing 21 is carried by a supporting late 22. This supporting plate extends vertically from this hearing 21, and adjacent its lower edge is provided with a bracket portion 22constituting a bearing for a pair of horizontal swinging supporting bars to be hereinafter referred to. There are two of these supporting plates 22, each of the form shown,-

and' each provided with a slot 24 and with notches 25 merging into this slot,-as maybe understood from Figures 1, 2"and 3. The

notches 25 serve as bearings, and asthere aretwo supporting plates 22,'each provided with these notches, there are of coursetwo 'setsofbearings. Resting inth'e notches-thus serving as bearings are a pair of pintles 26,

crease the height of the rocking board 27, the

latter thus being practically adjustable as to height. Either or both of the floor boards can be removed, so that the patient may sit either upon the rocking board 27 or upon one or more of the floor boards carried thereby. The rocking board 27 is cut away, so as to leave an edge portion 30'of arcuate form-as shown in Fig. 10. This shape is for promoting accessibility to the organs of the patient by the operator, for purposes of ex: amination and treatment. a The rocking board may be easily shifted into a number of different positionsby raising it slightly, so as to lift the ournal ins 26 from the notches in which they happen to rest, the rocking boardbeing then slightly shifted and lowered so as to bring the journal pins into other notches 25, as may be understood from Figure 1.

Thus the mountings which support the rocking board are movable back and forth, within reasonable limits permitted by the spacing of the notches.

The rocking board 27 carries a pair of lugs 31, preferably integral with it, and adapted to engage another pair of lugs 32, with which the supporting plates 22 are provided. By this arrangement the rocking board 27' is given a certain amount of freedom to rock,

but this movement is limited by the engagement of the lugs 31 with the lugs 32. The net result is that the outer or free edge of the rocking board 27-can be raised into the position indicated for it by dotted lines in Figure 1, but can not be lowered beyond the position indicated for it by full lines in this figure; or in other words, only far enough to render the general plane of the rocking board substantially horizontal, as indicated in Figure 1 a plate 33 serves as an end wall, and

to some extent conceals mechanism located below the table.

The back board 14 carries a casing 34 having substantially the form-of a flat box which is disposed between the back board 14 and the top portion 16.

Detachably fitted into one side of the cas-' ing 34 by aid of a slot 35, is a plate holder or casing 34 is an X-ray filter'340,'supported uponrollers one of which appears at 34d, the latter engaging a pair of rails one of which upon the bearings 20, 21..

is shown at 346. The X-ray'filter thus supported is movable-back and forthfor the purpose of wiping out thesecondary rays dur- This latter worm gear is arranged to, drive a-sniall drum 349' and a small cable, aportion of which isshown at 34k, encircles this drum.

The cable 347spasses around-the-drum 34jand around a pair of small idle pulleys '34Z dis-' posed at each end of the casing 34. The free ends ofthe cable 34% are secured to each side of the X-ray filter 34c and, depending upon thedirection of rotation of tl 1e.mo-tor,'the filter is moved in, one direction or the. other longitudinallyof the back board 14 and top portion 16. A pillow board 36 is utilized for supporting the head and shoulders of apatient and is adjustably arranged by .the provision of a pair of rack bars 37which are pivotally secured to th e pillow board} Pivotallyconnected with the back board 14 area pair of'rack bars39, 40, substantially alike, and each operated in a. manner which may beunderstood from Figure's4. and Q5. The rack bar 39 is engaged by a pinion 41 mounted as-indicated in Figure 5. The, pinion 41 is mounted upon a shaft42 andh'as relatively wide teeth which are engagedby a worm 43, the latter being fixedrigidly upon a shaft 44 extending nearly the full width of thetable. The shaft44 carries a collar 45 and a hub 46, the hub carrying a hand wheel 47 by therotation of which the shaft 44 may be turned. Thus the operator by turning the hand wheel 47 can cause the racks 39, 40 to be slowly raised and lowered,

and byfdoing this can causethe backboard 14 and parts carried thereby to swing bodily Theback; board 14 carries tube tube and a numb-erof parts 50. The purpose of this is .toenable the operator to bring; the X-raytube 49 into different posit-ionsofad 1 justinent. relatively to thetube column48 and to other parts. v V y The parts 50 are so adjusted as tobring the X-ray tube 49 into alinement withthe cassette 340, so thatv an irnaginaiy line. ex.- tending from the X-ray tube tolthe cassette is perpendicular to the face of the cassette, .and

'48, and supported by this column is an X-ray thus perpendicular to the sensitive plate carried by the cassette;- and also to the plane of the X-ray filter. I p r Mounted upon the brackets 22 ofthe mem. bers' 22, and; j ou'rna-led .to swing horizontally in relationthereto are azpairof supporting bars 52, and adj ustably' no-unted; upon these general supporting bars are a pair of supporting rods 53, which are adjustable relatively to the supporting bars 52. Carried upon the supporting bars 52 are a pair of leg supports 54, 55, for the purpose of supporting the patients legs by engaging the under side thereof at points adjacent the knees. 1 f v Theoperation of our device is as follows:

The patient is placed uponthe table, his head and shoulders resting upon the pillow board 36 and his back resting upon the top' portion 16. In this position his seat is upon a rocking board 27, his legs extending overthe leg supports 54 and 55. If desirable the-foot stool or equivalent support may be used for sustaining" the weight of his feet, and the tablecan be so tilted as to incline downwardly at the head; that is, into the Trendelensame time the X-ray-filter is operated, and a radiograph is taken in the manner well known in this art.

If, now, it be desired to take a second radiographwith the patient occupying a different position, say for instance sitting upright, the

Y operator merely actuates the hand wheel 47.

This raises the back board 14 as indicated in Figure 7, the movement being continued, if r'equired,until the patient sits upright, as indicated in Figure 8-. f

This is done Without the necessity for the patient moving a muscle, the net result bei; so

ing that the opaque solution remains in the kidneys, and the kidneys are therefore maintained in condition to be photographed by Ineans'ofthe X-rays I As-may be seen bycomparing Figures 6, 7 and 8, the, changes noted in the position of the movable parts of the table, and in the position of the patient as he is shifted from a recumbent position to a sitting'position, are accomplished without disturbing the relativelocation of the X-ray table, the cassette or plate holder, the X-ray filter with its operating mechanism, or any of the partsof the table which are shifted along with the'pa-tient. The single exception is the rocking board 27, which as above described can make a slight rocking, movement in one direction, but can not-exceed" a certain predetermined limit of trave'l in the opposite direction; or in other words, the rocking board becomes fixed when it reaches ahorizontal position. J

The patient being in. a sitting position, one

ori more additional racliographs may be taken, and these radiographs, or pictures location of the kidneys due to the shifting of the patients body can be readily detected and the patients condition as affected thereby may be determined accordingly.

We do not limit ourselves to the precise mechanism shown, as variations inaybe made therein without departing from our invention, the scope of Which is with our claims. 7

WVe claim: I V 1. A device comprising a table frame, a pair of supporting plates mounted upon said table frame and xtending upwardly therefrom, said supporting plates being each pro} vided with a plurality of notches serving as bearings, and a rocking board provided with journal pins for removably fitting into said notches and thus supporting said rocking board while allowing said rocking board to rock. r

2. A device comprising a frame, a back board journaled thereupon, a pillow board carried by said back board and adjustable commensurate relatively thereto, mechanism connected with said frame and with said back board andcontrollable by the operator for shifting said back board to different angularpositions relatively to said frame, a rocking board adjustably journaled upon said frame and movable tojvarious angular positions inclependent of the movements of said back board, an X-ray tube carried by said back board and movable relatively thereto to enable said X-ray tube to maintain a predetermined normal position relatively to said back boardwhen said back board is shifted relatively to said frame,'and means for supporting 3. A. device comprisin'ga table frame, a

table top carried bysaid table frame and AJA device comprising a table 'frame,-a

tabletop carried by said table frame and adjustable relatively. thereto, anX-rayfilter carried by said table top, a pair of supporting plates mounted" upon'said table-frame and extending upwardly therefrom, a rockan X-ray plate within 7 said back board. i I

ing board pivotally mounted upon said supporting plates and free to rock relatively to said table frame, an X-ray tube carried by said table top and having a predetermined fixed position relatively to said table top' rality of bearings, a rocking board provided with pintles for engaging said bearings, said pintles being removable from one pair of sa1d bearings to another pair thereof in .or-

der to enable said rocking board to be shift- 7 ed bodily from one position to another relatively to said supporting plates, an X-ray tube, an X-ray filter and mechanism for ac-' tuating said X-ray filter, all carried by said table top, so that said X-rayfilter may be kept focused upon said X-ray'tube independently of the tilting of said table top, and

means for limiting rocking movements of. sa1d rocking board relatively to sa1d supporta ing plates.

6. A device comprising a table frame, a table top mounted upon said table frame and adjustable relatively thereto, mechanism connected with said table top and controllable by the operator for shifting said table top relatively to said table frame, a plate holder carried by said table top and normally occupying a fixed position relatively thereto, an X-ray tube, an X-ray filter and mechanism for actuating said X-ray filter, all carried by said table top, and a rocking board connected with said table frame and serving as a seat for a patient, said rocking-board being movable independently of the inclination c of the table top.

7. A device comprising a table frame,a

table top journaled upon said table frame,

mechanism connected with said table top and table frame and controllable by the operator for shifting said table topvinto different angular positions relatively to said table frame, a plate holder carried by said table top, mechanism carried by said table top for supporting an X-ray tube in a pre determined normal position relatively to said plate holder, an X-ray filter carried by said table top and movable therewith as said table top is shifted into said different angular positions relatively to said table frame, and a rocking board detachably supported upon said table frame and adjustable bodily into different positions relatively thereto, said rocking board being free to rock in each of its said different positions, and means for limiting the rocking movement of said rocking board.

ARTHUR MUTSCHELLER.

CARL JOHAN LARSEN. 

